Individual provider Active NPI

Susan Pilar Gresia, LICSW

  • Clinical Social Worker
  • Olympia, WA
National Provider Identifier
1831653179
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60606394 Issued in WA
Practice address
525 Lilly Rd NE Ste 250
Olympia, WA 98506-5101
Phone
(360) 486-6777
Fax
(360) 412-2252
NPI assigned
Jan 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LW60606394 WA Primary

Addresses

Primary practice location

525 Lilly Rd NE Ste 250
Olympia, WA 98506-5101

Mailing address

PO Box 3360
Portland, OR 97208-3360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190719002409 WA Practitioner - Clinical Social Worker 4981930534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

204 Custer Way SW
Suite B5
Tumwater, WA 98501-3330
Phone (360) 250-0960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW60606394WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington Clinical CurrentSince May 21, 2019 Accepting new patients
Gresia Counseling & Wellness, PLLC Clinical CurrentSince Mar 5, 2021 Accepting new patients

Locations

525 Lilly Rd NE
Ste 250
Olympia, WA 98506
Phone (360) 413-8470

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

204 Custer Way SW
Ste B5
Tumwater, WA 98501
Phone (360) 250-0960

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1831653179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 LILLY RD NE STE 250",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065101",
            "telephone_number": "360-486-6777",
            "fax_number": "360-412-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESIA",
        "first_name": "SUSAN",
        "middle_name": "PILAR",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60606394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.